The Revelation

October 20, 2007

After spending half a decade wandering in med school, it now kinda feels something like this…

I see the light!

Suddenly, it all comes together.

Pre-med school, I thought…

…doctors are cool.

…medicine is a very noble profession where people alleviate suffering in the most direct and truest sense.

…I’m gonna bolt the moment I start dissecting cadavers.

…everyone would be incredibly busy.

…medicine is horrifyingly tough and scary, and I’d crap myself.

Post-med school, I now realise…

…doctors are plain weird…but nonetheless cool hah! *smirks*

…medicine is indeed a noble profession, but after sticking your finger in countless rectal examinations it reminds one that glamour is over-rated.

…I’m in awe of the human body; I didn’t run for the door when I was instructed to free a headless cadaver from the body bag during anatomy class. I remember looking under the metal table in search of the head. But then again, I have a misplaced sense of fear; my nerves react more towards living beings (e.g. my consultant, my examiner, traffic police, angry parent, etc.)

…everyone is incredibly busy sleeping. Especially me.

…after 5 years of study, it all comes together (somewhat!)…and I still crap myself from time to time.

I’m fairly certain there’s gonna be another list like this once I survive through my internship. Reality is a constant, and hopefully so would my half-baked sense of humour.

Stay tuned.

 

Con’t from previous post :-

Act #5

The grumpy head surgeon. I was forewarned of a particular Very Important Person whom is infamous of kicking juniors out of the operating theatre should they fail to answer his questions correctly. Most of his questions reflect his immense passion in Anatomy – and my memory/knowledge/guesses on the subject can be comparable to a píg’s ability to fly.

I thought, oh noes. I have entertained the idea of maybe sneaking into the operating room un-noticed and attempting to appear inconspicuous so as not to be called into the line of fire. But then again, it’s not fool-proof and in fact I foresee it failing so miserably – trying to blend into the white wall while donning all blue is akin to getting a Smurf remaining unseen while trekking across the Artic.

Ah, putting my lazy self aside I decided that this would be a good time to read up on my stuffs. It’s ultimately for my own benefit; the pursuit of higher knowledge as we so nobly call it as well as to perhaps alleviate the sudden urge to empty my bladder each time I see him entering the operating room.

Being in the Colorectal unit, everyone here is mainly interested in only the last 10 centimetres of bowel up from the anus. I am well aware that the butt is indeed a pretty celebrated region in the study of anatomy, but I must say I never pored over it as much as this before. Contrary to the notion that it’s “only 10 centimetres”, I’ve discovered that it is in fact a huge circus going on down there. I humbly bow to the various researchers /doctors/surgeons/what-not who’ve spent great amount of time unravelling the mysteries surrounding the last bit of our gut. Such dedication, such enthusiasm – hey I’m serious here!

Having laid out my plan (and life as it has always been), what if I still end up getting myself kicked out of the operating room?

*ponders*

I think I’ll head down to the cafe then to grab some milk tea and read the papers.

*   *   *

“Imagination is a quality given to man to compensate him for what he’s not, and a sense of humour provided to console him for what he is”

– Oscar Wilde –

Funny how things are going lately.

Maybe it’s nearing the end of the year. Maybe it’s nearing the end of my studies (after 5 long years, man!). Maybe it’s just my brain taking off and leaving me to negotiate my everyday routine.

I noticed that I’ve been more oblivious towards the usual grind and instead suddenly appreciate the heightened ability to see humour (albeit inappropriately sometimes) behind my every day events. Maybe it’s an innate self-defense mechanism as I’ll be diving head first into the working world?

Act #1

I was tagging along at the usual ward round not too long ago and we were told a lady had just been admitted for a suspected stroke. She presented with a one-sided facial droop and usually one would be expected to assess the degree of weakness of the facial muscles. My registrar had intended to request the patient to clench her teeth together (to ellicit any obvious muscle weakness which may manifest asymmetrically) but instead he flung the curtains to the side and bellowed (patient was hard of hearing) :-

“Mrs. A, show me your teeths!!”.

Needless to say, I think he meant teeth for the plural of tooth and of course…we all heard it as :-

“Mrs. A, show me your tits!!“.

Oh yikes. But I must admit, seeing him casting aside the curtains with a flourish while hollering loudly the mis-heard request added some granduer.

Act #2

I was at the Emergency Department for this one. I was reading through a patient’s list of medications and I did a double take at one of the drugs prescribed.

It was charted as Mogadon, once daily every night. Mogadon is the brand name for Nitrazepam, which is a sedative known for its potent anti-anxiety properties.

I’m not sure if it was the lack of breakfast, or the lack of sleep, or maybe I stood shampoo-ing my hair far too long…but for a second I glanced through it and saw :-

Megatron, once daily every night.

Act #3

There I was in the operating theatre standing in for a colorectal procedure. The patient was already knocked out on the table (being administered some general anaesthetic) and the theatre staff were preparing him for colonoscopy. Usually it doesn’t require one to be sedated as such but imaging scans has shown the presence of an irregular tumour (cancerous) residing in the rectum, and to probe the lesion under normal circumstances could result in too much pain and bleeding from the patient – hence the decision to knock him out first.

Prior to any the introduction of any form of scopes into the patient’s anal canal, the usual protocol requires a digital rectal exam to be performed first. The head surgeon requested that the intern and the med student (me!) should take turns to do a rectal examination and report our findings back to him.

So both us newbies (one greener than the other) slapped on some gloves and armed with a squeeze of lubricant; I opted to do the rectal examination first so I tentatively introduced my forefinger into the patient’s anal canal and felt around a bit for any irregularities – which there were. This is part of the cancerous growth in his bowels that I was palpating.

Once done, my gloves were off and I stepped aside for the intern to take his turn. I wasn’t really paying attention to what the intern was doing…in fact I was looking around checking out the various machines and pumps until the head surgeon’s voice boomed and echoed throughout the room.

“Why are you using your middle finger?”.

The room fell silent. I turned around and saw the intern had his middle finger knuckle-deep up the patient’s bum and he had this puzzled expression on him.

“Um, because it’s longer?”, he murmured.

The surgeon suddenly went into hysterics. “Because it’s longer??“, he repeated and started laughing his head off. Everyone in the room started laughing along and the intern was alternating his glances between me and the surgeon (both of us were standing closest to him). The newbie doc looked like he thought he had sinned badly until the surgeon patted him reassuringly on the shoulder and muttered:-

“I thought you had something against this patient!”, exclaimed the surgeon as he proceeded to mimic the middle finger salute at the unconscious patient to prove his point.

Act #4

Speaking of surgery, did I mention that one of my greatest fears while in the operating theatre is to have my blue scrub pants fall off me?

If I’m not mistaken, the scrub pants provided at where I’m at comes in exceptionally large sizes (looks huge to me) with a side drawstring. Twice a week, I’d be wearing those around the hospital as my unit would be having their allocated theatre day so I could pop in and out of surgeries readily-dressed for the occasion.

During my first theatre day, I spent a good few minutes rummaging the scrubs rack for something which is nearer to my size. They were all neatly folded and stacked; pity the unfortunate personnel who had to deal with the aftermath of my searching thereafter. Each piece of garment that I’ve unfolded appears to be pretty oversized till it’s almost like I’m holding enough fabric to make the national flag.

I’ve managed the find a top which sleeves are at least above my elbows (for convenience). The pants however look almost  all the same (huge sea of blue) and I resorted to pulling the drawstrings horrendously tight to secure the garment in place. Putting the pants on would be something akin to one stepping into a parachute; feels light and breezy with a huge amount of space between your legs and the material.

Once dressed, it’s off to the operating table. Here, my list of concerns acutely arise even more so. Being neurotic, I even had a game plan in my head in the event of unforeseen/undesirable circumstances.

Q : What if my pants come loose while watching the surgery?

A : Find a stool and sit down. That way even if it came loose I’d not subject myself to any immediate embarrassment until I stand up. But of course, I hope I would able to feel it loosening so I could redo the knots.

Q : What if I tripped over my huge pants and rip the knots off?

A : I can’t guarantee how much force I would apply to the cloth should I trip on it BUT I certainly do have a degree of control over how tightly I make the knots. I resign to hiking up my pants really high up on my waist (they’re huge and lengthy) and tie/yank/braid the drawstring so fastidiously in a manner could possibly put the surgeon himself to shame (pfft!). If I were to trip on it, I hope they would able to withstand the sudden jerk (and me getting this sudden Heimlich manouver from the garter) and NOT fall.

Q : What if I’m assisting in a surgery for hours and I can’t even sit?

A : Pray. And get a nurse to hike your pants up for you. Or suture it in place.